辽宁省大气污染与出生缺陷相关性分析

Correlation between air pollution and birth defects in Liaoning province

目的探讨大气污染与出生缺陷之间是否具有相关性.方法以妊娠期间居住于辽宁省、末次月经位于2006年1月1日-2015年12月31日间分娩出生缺陷患儿的孕产妇共计58744例为研究对象,利用辽宁省14个城市71个大气监测点的污染结果,分析妊娠妇女在大气污染较严重的季节中,妊娠前后暴露于大气污染物中与分娩缺陷儿之间的关系。结果辽宁省冬、春季为污染较严重的季节,全省缺陷发生率为183.67/万,出生缺陷前五顺位分别为先天性心脏病、唇腭裂、多指(趾)、脑积水、外耳畸形,五类缺陷占总缺陷的51%。末次月经位于冬、春季节的孕母孕2月、整个孕期的NO2浓度、孕3月、孕5月、整个孕期的API值、孕初月SO2、孕3月PM10与胎儿发生先心病具有相关性,孕4月SO2与多指(趾)的发生具有相关性,孕初月、孕4月SO2与外耳畸形的发生具有相关性。结论孕期部分月份暴露于大气污染地区与部分出生缺陷的发生具有相关性。

Objective To investigate whether there is a correlation between ambient air pollution and the incidence of birth defects. Methods The data on 58 744 live births with birth defects were collected in Liaoning province among 3 198 348 puerperae having last menstrual period between January 1st, 2006 through December 2015. We also collected data on ambient air pollution during the same period from 71 monitoring sites in 14 cities across Liaoning province. The associations of exposure to various air pollutants of the puerperae before and after pregnancy with incidences of different types of birth defects were analyzed. Results Heavier ambient air pollution in winter and spring seasons were observed during the period in the province. The total incidence of birth defects was 18.67/10 000 for all the live births. The top five defects were congenital heart disease, cleft lip and palate, polydactyly, hydrocephalus and external ear malformation, altogether accounting for 51% of all the birth defects observed. For all the live births of the puerperae with their last menstrual periods in winter and spring seasons, the incidence of congenital heart disease was associated with following exposures: concentration of nitrogen dioxide (NO2) during the second month or whole duration of pregnancy, air pollution index (API) during the third or the fifth month or whole duration of pregnancy, sulfur dioxide (SO2) during the first month of pregnancy, and particulate matter less than 10 μm in aerodynamic diameter (PM10) during the third month of pregnancy;the incidence of polydactyly was related the exposure to SO2 during the fourth month of pregnancy;the incidence of external ear malformation was correlated with exposures to SO2 during the first month or the fourth month of pregnancy. Conclusion Maternal exposure to air pollution during some months of pregnancy is associated with incidences of some birth defects.